In 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills ( 2). An estimated 20% of patients presenting to physician offices with noncancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription ( 1). Opioids are commonly prescribed for pain. CDC has provided a checklist for prescribing opioids for chronic pain ( ) as well as a website ( ) with additional tools to guide clinicians in implementing the recommendations. This guideline is intended to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death. It is important that patients receive appropriate pain treatment with careful consideration of the benefits and risks of treatment options. CDC obtained input from experts, stakeholders, the public, peer reviewers, and a federally chartered advisory committee. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, and recommendations are made on the basis of a systematic review of the scientific evidence while considering benefits and harms, values and preferences, and resource allocation.
The guideline addresses 1) when to initiate or continue opioids for chronic pain 2) opioid selection, dosage, duration, follow-up, and discontinuation and 3) assessing risk and addressing harms of opioid use. This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.
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